Tinnitus: systematic approach to primary care assessment and management

[摘要] INTRODUCTION Tinnitus is a symptom in which patients report the perception of sound in the absence of external stimuli.1 The nature of the sound is variable; it may include buzzing, ringing, humming, or whistling. Tinnitus affects up to 15% of the population.1–4 It affects all ages but is most common in older people with presbycusis.2,4 Two per cent are significantly affected, reporting reduced quality of life outcomes.1,4 A recent international systematic review estimated the cost of tinnitus management to be as high as 7246 Euros (6115 GBP) per patient per year.1 Despite this disease burden, the pathophysiology of tinnitus remains poorly understood.2,5 It is thought to be multifactorial in nature, resulting from dysregulated neural activity at any point along the auditory pathway from the cochlea to auditory cortex.1,2,5 The perception of tinnitus is associated with hearing loss or being in a quiet environment because of a lack of masking by background noise.1,2,6 Tinnitus may present as an isolated symptom or may be indicative of a range of pathologies from benign conditions to clinical emergencies.2 It may also pose a significant psychosocial burden on patients and is associated with anxiety and depression.

[学科分类] 卫生学